No difference in pain control and hospitalisation length between single-shot adductor canal block and periarticular injections following total knee arthroplasty: a meta-analysis.

Abstract

This meta-analysis compared pain control and hospitalisation length between single-shot adductor canal block (ACB) versus periarticular injections (PAI) following total knee arthroplasty (TKA). The 2020 PRISMA guidelines were followed. Embase, Web of Science, and PubMed were accessed in August 2025 without additional filters or temporal constraints. All randomised controlled trials (RCTs) comparing single-shot ACB versus PAI for pain management following TKA were considered. Data concerning the visual analogue scale (VAS) were collected for postoperative day (POD) 0, 1, 2, 3, and at discharge. Data on the length of the hospitalisation were also retrieved. Data from 283 patients were retrieved, 75.3% of whom (213 of 283) were women. The mean length of follow-up was 2.8 ± 2.3 weeks. The mean age was 69.2 ± 1.9 years, and the mean BMI was 31.0 ± 1.1 kg/m². No difference was found in the length of the hospitalisation (P = 0.06). No difference was found in VAS at POD0 (P = 0.9), POD1 (P = 0.1), and POD2 (P = 0.5). No difference was found in pain control and hospitalisation length between single-shot adductor canal block and periarticular injections following total knee arthroplasty. Obviously, when selecting one method over the other, consideration should be given to the fact that most surgeons are able to administer PAI, while ACB may require a specialised trained anaesthetist and the use of an ultrasound machine.